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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1443176



Case Details

VAERS ID: 1443176 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-29
Onset:2021-06-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Nervousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received first dose of Pfizer vaccine in left arm at 1128 06/29/2021. Patient stated he was very nervous to get his vaccine when he arrived. Patient was sitting in observation when he stood up to alert someone he was dizzy. Patient started to lose consciousness while a nurse was able to catch him and lower him to the ground safely. The patient''s legs were elevated and patient regained consciousness. Blood pressure taken at 1130 and was 105/55 with a HR between 46/52 BPM. The second BP was taken after the patient sat up. At that time, he was 124/64. The patient verbalized that he hadn''t eaten anything that day, so staff got him apple juice and crackers which he started to eat/drink immediately. The third blood pressure was 146/68. At this time, the patient verbalized he felt safe to sit in a chair. All blood pressures taken on left arm. Patient denies any dizziness at this time. Additional vitals BP 128/81, HR 57 -- $g 126/77, 59 prior to D/C. Pt stable and released from the vaccination site.


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